Individual provider Active NPI

Chase L. Vervack, O.D.

  • Optometrist
  • Oklahoma City, OK
National Provider Identifier
1285947895
Registry record updated Jul 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2673 Issued in OK
Practice address
2501 W Memorial Rd Ste 222
Oklahoma City, OK 73134-8019
Phone
(405) 775-9300
Fax
(405) 775-9303
NPI assigned
Jul 24, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2673 OK Primary

Addresses

Primary practice location

2501 W Memorial Rd Ste 222
Oklahoma City, OK 73134-8019

Mailing address

2501 W Memorial Rd Ste 222
Oklahoma City, OK 73134-8019
Phone (405) 775-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101202000586 OK Practitioner - Optometry 8325234305 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14110 N Pennsylvania Ave
Suite 1
Oklahoma City, OK 73134-6199
Phone (405) 775-9300

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2673OKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Butcher Optical I, PC Optometrist CurrentSince Jan 1, 2013 Accepting new patients
Butcher Optical III, Inc Optometrist CurrentSince Jan 1, 2013 Accepting new patients
Butcher Optical II, PC Optometrist CurrentSince Jan 1, 2013 Accepting new patients
Jeffrey M. Butcher, OD, PC Optometrist PastSince Jan 1, 2013 Accepting new patients

Locations

13553 State Road 54
Odessa, FL 33556
Phone (303) 929-3420

1369 24th Ave NW
Norman, OK 73069
Phone (405) 366-1110

14110 N Pennsylvania Ave
Ste 1
Oklahoma City, OK 73134
Phone (405) 775-9300

7308 NW Expressway
Ste 100
Oklahoma City, OK 73132
Phone (405) 720-8316

8549 N Rockwell Ave
Oklahoma City, OK 73132
Phone (405) 720-8316

2501 W Memorial Rd
Ste 222
Oklahoma City, OK 73134
Phone (405) 775-0400

510 E Memorial Rd
Ste A4
Oklahoma City, OK 73114
Phone (405) 777-4726

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279929600000",
    "number": "1285947895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 W MEMORIAL RD STE 222",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731348019",
            "telephone_number": "405-775-9300",
            "fax_number": "405-775-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 W MEMORIAL RD STE 222",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731348019",
            "telephone_number": "405-775-9300",
            "fax_number": "405-775-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERVACK",
        "first_name": "CHASE",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-24",
        "last_updated": "2010-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.